break. the senate's a dif rent matter, but they believe they can pass large chunks of reform that would only require them to have a 50 plus 1 majority in the senate. the people they're losing they don't need. >> jonathan capehart is part of the independents who may not be decided yet. what are you looking to see from the president's town hall today? is there a moment or a particular issue that you think the obama white house needs to tackle head on that might sway independents? >> that's a good question. i'm not sure how much sway the whole nonexistent death panel question is for people out there. i think the president hitting that issue head on and like reminding people that you know, this is just not the case, not sure if independents really care about that. it could be the question of -- lost my train of thought, but

it's the -- the provision -- public option. that's it. >> there we go. >> sorry about that. and whether independents really worry about or want or demanding a public option. yesterday, i think it was we asked chuck todd on "morning meeting" whether the president would you know back away from a public option and i thought there was a little bit of daylight there. we have to remember one thing. the congress, house and senate, they're still negotiating a bill and these town hall forums have been a problem because they're battling -- >> i hate to interrupt -- we've got to let our audience know that senator max baucus at the podium now. you also saw the governor.

let's listen in as this town hall starts now. >> you know, growing up here in montana, wlerned values like hard work and common sense, also the difference between right and wrong. and it's just plain wrong for insurance companies to devalue coverage when you get sick and need it the most. and it's just plain wrong for insurance companies to deny people of care because of preexisting conditions. and that's why we're working so hard to craft a common sense plan that is right for our state and right for america. here in montana, we also know the value of an honest word. and let me tell you, there's plenty of dishonesty out there about what health care reform will or will not do. now, you've all seen the tv

show, "myth busters," right? well, i've been going around the state busting myths about health care. whether it's bogus information about rationing care, cutting benefits for seniors or -- doctor and patient relationship, these outrageous myths are being questioned -- >> it appears that we're returning into technical problems at this town hall meeting in montana. it's gallatin field airport hangar. david schuster is still with me, but interesting note. senator baucus taking on first off, health insurance and what people are paying and the coverage that they're not getting. you saw pelosi and even the president now focussing the health insurance industry as perhaps the bad guy in this. >> he said it's not okay for the insurance companies to deny people with pr existing conditions coverage, it is okay for him to take a lot of contributions.

the third largest contributor is blue cross. you have to take some of what the politicians say with a grain of salt. sure, people hope he's going to say he's going to push reform on them and some insurance companies may be okay with some of the reforms -- >> i don't think anyone wants to say that and there are others, by my point being that perhaps he knows the talking points. perhaps he's gotten the memo that this is the direction this administration wants to go in and really focussing on the people who have health insurance, but are not happy or are worried about preexisting conditions and some of those loopholes. i think it's a way to fight back on some of the conversation of rationing that still happens and has nothing to do with a government program. i think maybe that's where he's going with this as we've heard it from other democrats.

>> part of this is that this is sort of like the second of three chapters. we had the chapter in new hampshire, we're going to have another similar exacter today involving this woman and what she's talking about her own personal experience. let's listen again. she's going to talk about her own experience and then introduce president obama. >> i was also lucky to have excellent health insurance through my employer at the time, hewlett-packard. >> okay, we are again -- we apologize certainly for this. i don't know if this is because it's in an airport hangar or equipment problems, but again, what we're trying to bring to you of course is the second town hall this week from president obama. he's holding another tomorrow in colorado. the tickets were handed out on a

first come, first serve. this may present an opportunity for more challenging questions. the which will we did not see in new hampshire. >> and the opportunity for some feisty exchanges and traps the president's opportunity to leverage that emotion and hit back or counter it. that's obviously a difference dynamic. seems like the signal's back. let's try again. >> so we had to search for new insurance. we couldn't afford to pay $25,000 out of pocket every year so we had to search for new insurance. this is not easy when you're a cancer survivor. one insurance company after another refused to cover me because they said i had a preexisting condition. finally, a company accepted me. but to be totally safe, i kept my old coverage for a month after the new coverage started. just to be sure the new company was going to cover me.

everything seemed fine, but several months later, the new insurance company called to say they had changed their minds. that my insurance had been rescinded retroactive to the beginning of the policy. so now, not only did i not have insurance, my record indicated a long lapse in coverage, so i couldn't get coverage and my first health insurance company wouldn't take me back. so we called the montana state insurance commissioner's office and they intervened for us. through a state-backed program, i'm now once again fully covered. we were lucky enough to negotiate these mind fills, but others are not so lucky. one of the truly difficult things i faced was at the same time i was very ill and should have been spending my limited energy on my health, i was instead worrying about --

>> we're still running into the technical problem and for the record, it's not just happening with our network. our producers say it's because of the weather there. when we saw the president and first family land, i didn't see any rain unless i was looking at the wrong shot. that was the arrival of sasha, malia and of course the first lady, michelle obama, but they're telling us it's the weather. the president just being introduced. let's listen in.

>> hello, montana! hello, montana! thank you. thank you. thank you. it's great to be here. please, everybody, have a seat. thank you so much. thank you. i am excited to be back in montana. i want to -- where's michelle? what is this, chopped liver here? michelle and the girls were supposed to go white water rafting. now, i just heard there's some rain out there, so i don't know what's going on there, but they're on their way. i want to first of all

acknowledge some outstanding public officials and great friends. first of all, the man who is working tirelessly to make sure that the american people get a fair deal when it comes to health care in america, please give max baucus a big round of applause. one of my favorite people in washington, probably because he hasn't gone washington, still gets the same haircut, give it up for john tester. your on star here in montana,

please give your governor and his wife a big round of applause. the lieutenant governor is here. the mayor of belgrade is here. the mayor of boez man is here. and somebody who i believe is destined to be one of the greatest secretaries in history, ken salazar is here. please give ken a big round of applause. it is nice to be back. it's nice to take a break from

the going onin washington. i'm thrilled to spend time with the folks in this state. you've got bears, moose and elk. in washington, you just have mostly bull. so this is a nice change of pace. being in montana. i especially want to thank katie for her introduction. where'd katie go? there she is right there. katie's willing to talk about such a painful experience is important. because we have to understand what's at stake in this health care debate. katie's story is the kind of

story that i've read in letters all throughout the campaign and every day when i'm president. i hear about them in town halls all across america. the stories of hard working people who are doing the right thing. they're acting responsibly, only to find out that they're penalized only because others aren't doing the right thing. because others aren't acting responsibly. on tuesday, i was in new hampshire taking to people who had been denied coverage because of preexisting conditions. today, we're talking about people like katie, who have had their insurance suddenly revoked. they got sick and suddenly, that's when they get dropped. tomorrow in colorado, we'll be talking about the people who have insurance, but are still stuck with huge bills because they've hit a cap on their benefits or are charged large

fees. when you hear about these experiences, when you think about the millions of people denied coverage because of preexisting conditions, when you think about the thousands who have their policies canceled each year, i want you to remember one thing. most of us have -- most of us have insurance and most of us think you know, knock on wood, that we're going to stay healthy, but we're no different than katie and other ordinary americans. we are held hostage at any given moment by health insurance companies that deny coverage or drop coverage or charge fees that people can't afford at a time when they desperately need care. it's wrong. it's bankrupting families. it's bankrupting businesses.

and we are going to fix it when we pass health insurance reform this year. we are going to fix it. again, i want to especially thank max for his hard work on a bill as chair of the finance committee. he has been committed to getting this done. this is obviously a tough time in america. a tough time in montana. just six months ago, we were in the middle of the worst recession in our lifetimes. we were losing about 700,000 jobs each month. that's why we acted as fast as we could to pass a recovery plan to stop the free fall. i want to speak briefly about the recovery plan because that has colored how people view the health care debate.

it was divided into three parts. 1/3 of that money went to tax cuts that have started showing up in the paychecks of about 400,000 working families in montana. 400,000 working families have seen their taxes reduced because of the recovery act. we also cut taxes for small businesses on the investments they make and more than 200 montana small businesses have now qualified for new loans, including ten right in the bozeman area. another third is for emergency relief. what am i talking about? unemployment insurance? we've extended benefits for 40,000 montana residents.

we've made health insurance 60% cheaper for families who rely on cobra. i think as your governor will testify, for states facing budget shortfalls, we provided the assistance to save the jobs of tens of thousands of workers who provide essential services like teachers and police officers. we've prevented painful job cuts and tax increases. so that's 2/3 of the recovery act. the last third is for investments that are already putting people back to work. rebuilding infrastructure. there are nearly 70 transportation projects already approved here in montana. these are jobs fixing up the roads leading to the national fores forests. most of the work is being done by local businesses because that's how we're going to get this economy growing again.

so there is no doubt that the recovery plan is doing what we said. putting us on the road to recovery. we saw last friday, the jobs picture beginning to turn. we're starting to see signs that business investment is coming back. so people i think sometimes when i listen to them on tv or these cable shows, they seem to have a selective memory. we started with this mess. we are now pulling out of it, but that doesn't mean we're out of the woods. that doesn't mean we're out of the woods. you know that. in bozeman, the jobs center reported seeing 8,000 job seekers. we can't do nothing while families are struggling because even before this recession hit, we had an economy that was working pretty well for the

wealthiest americans, for bankers and big corporations, but not so well for everybody else. it was an economy of bubbles and busts. it was an economy of which wrecklessness and not responsibility was rewarded. we can't go back to that economy. we have to lay a new foundation for lasting prosperity. and health insurance reform is one of the key pillars of this new foundation. we're going to tell folks like katie -- until companies -- to pay for health, until every single american has the security and peace of mind of knowing they've got quality, affordable care. and the fact is, health care

touches all of our live ins a profound way. that also makes this debate an emotional one. i know there's been a lot of attention paid to some of the meetings going on around the country. especially when tempers flare. tv loves a ruk us. what you haven't seen are the many constructive meetings. everywhere across the country, you're seeing people who are coming together and having a civil, honest, often difficult conversation about how to improve the system. that's how a democracy is supposed to work. earlier this week, i held a town hall in new hampshire. a few thousand people showed up. some big supporters of the reform. some had concerns about questions. but i was glad to see that

people were there not to shout. they were there to listen. and to ask questions. that reflects america a lot more than what we've seen covered on television for the last few days. and i want to thank you for coming here today in that spirit. before i take questions, i just want to talk briefly about what health insurance reform will mean for you. we still have work to do in congress. the bills aren't finalized, but i just want you to understand about 80% of this has already been agreed to and here are the basic principles that folks are talking about. first, health insurance reform will mean a set of common sense consumer protections for folks with health insurance. so those of you who have health

insurance, this is what it will mean. insurance companies will no longer be able to cancel your coverage because you get sick. that's what happened to katie. it can't happen anymore. if you do the responsible thing, if you pay your premiums each month so that you are covered each month because of a crisis, when that crisis comes, your husband has a heart attack, your son our daughter is rushed to the hospital at a time when you're most frightened, you can't be getting a call from your insurance company saying your insurance is revoked. it turns out once you got sick, they scoured your record looking for reasons to cancel your policy. they find a mistake from years ago. that can't be allowed to happen. one report found three insurance companies alone had canceled

20,000 policies over the past few years. one man from illinois lost his coverage in the middle of chemo therapy because he hadn't reported gallstones he didn't know about. because his treatment was delayed, he died. a woman from texas was diagnosed with an aggressive form of breast cancer and was scheduled for surgery. three days before, the insurance company canceled the policy because she forgot to declare a case of acne. this is personal for me. i'll never forget my own mother as she fought cancer in her final months, having to worry about whether the insurance company would refuse to pay for her treatment. they were arguing that she should have had known she had

cancer even though she hadn't been diagnosed yet. when we pass health insurance reform, we're going to put a stop to it once and for all. that is what max baucus is working on. two, insurance companies will be prohibited from denies coverage. a report found that more than 12 million americans were discriminated against because of a preexisting condition. no one holds these companies accountable for these practices, but we will and insurance companies will no longer be able to place an arbitrary cap on the amount of coverage you receive in a given year or lifetime and that will help -- 3700 households in montana. we'll place a limit on how much you can be charged for out of pocket expenses as well because

no one in america should be broke when they get sick. and -- finally, finally, we'll require insurance companies to cover routine check-ups because that saves money and lives. so that's what health care reform is all about. right now, we've got a system that works better for insurance companies than the american people. we want to change that. now, if you are one of nearly 46 million people who don't have health insurance, you'll finally have quality, affordable options. and if you do have health insurance, we'll help make sure it is more affordable and more secure. if you like your health care plan, you can keep your health care plan. this is not some government takeover. if you like your doctor, you can

keep seeing your doctor. i don't want government bureaucrats mettling in your health care, but i also don't want insurance company bureaucrats mettling in your health care either. that's what reform's about. now, let me say this. under the proposals that max is working on, more than 100,000 middle class people in montana will get a health care tax credit. more than 2,000 will have access to a new marketplace where you can easily compare health insurance options.

nearly 30,000 small businesses in montana will be helped by new tax benefits as well. and we will do all this without adding to our deficit over the next decade. largely by cutting waste and ending deals for insurance companies that don't make anybody any healthier. so -- the fact is, we are closer to achieving reform than we have ever been in risry. we have the american nurses association and american medical association on board because america's doctors and nurses know how badly we need reform. we have broad agreement in congress on about 80% of what we're trying to achieve and we continue to work on the other 20%. we have an agreement from the drug companies, who opposed reform in the past, to make prescriptions more affordable for seniors. the aarp supports this and

agrees that reform must happen this year. but because we're getting close, the fight is getting fierce. every time we are in sight of health care insurance reform, the special interest fight back with everything they've got. they use their ads and their political allies try to scare is heck out of everybody. it happened in '93, it's happening now. it happened when lyndon johnson tried to propose health care, when john f. kennedy tried to proprose medicare. for all the scare tactics out there, for all the scare tactics out there, what is truly scary, what's truly risky is if we do nothing. if we keep the system the way it is right now, we will continue to see 14,000 americans lose their health insurance every day. and that could be you.

premiums will continue to skyrocket, rising three times faster than wages. that will be you. the deficit will continue to grow. medicare will go into the red in less than a decade. so for all the seniors out there who are understandably are worried about medicare, understand that if we don't reform the system, in about eight years, medicare goes in the red. and given the deficits we have now, we've got to start thinking how are we going to pay for that. insurance companies will continue to profit by discriminating against people for being sick. if you want a different future, a brighter future, i need your help. change is never easy. and by the way, it never start ins washington. it starts with you. so i need you to keep knocking on doors, talking to your neighbors, spread the facts. fight against the fear.

this is not about politics. this is about helping the american people and if we can get it done this year, the american people are going to be better off. thank you, montana. thank you. thank you. all right. everybody have a seat. the -- so -- we are going to try to take as many questions as we can. in the time that we've got and we haven't preselected anybody. or prescreened the questions. all we want to do is just ask you to raise your hand if you've got a question and i'm going to go girl, boy, girl, boy so i don't get into trouble. there are people in the audience with microphones as you can see.

so if you can, once i call on you, if you could just wait until they bring the microphone, stand up so we can all see your lovely face and introduce yourself and i'll answer the question. and if you could keep your questions relatively brief, i'll try to keep my answers relatively brief. all right. this young lady right here in the blue blouse. right there. >> hi, mr. president. thank you so much for coming to southwest montana. we really appreciate you being here. >> great to be here. >> my name is carol wilder. i was laid off in january. i'm uninsured. my two children have medicaid. without going into too much detail, can you tell us if you have kind of looked at canada,

the england system and sort of, can you pick and choose from those systems that work that we see there is some success rate and apply that to what you're trying to push through right now? >> let me tell you what happens in other industrialized countries. first of all, i think it's important for everybody to understand that americans spend 5 to $6,000 per person more than any other advanced nation on earth. a 5 or $6,000 more than any other person -- any other country on earth. now, if you think that how can that be, well, you probably don't notice it because what's happening is if you've got health insurance through your job, more and more of what would be your salary and wages is going to health insurance. but you don't notice it. you just don't that you're not getting a raise. but a bigger and bigger portion

of compensation is going to health care here in the united states. now, that's point number one. so clearly, we've got a system that isn't as efficient as it should be because we're not healthier than people in these other countries. having said that, most other countries have some form of single payer system. there are differences. canada and england have more of what people would call a socialized system in the sense that government owns the hospitals, directly hires doctors, but there are a bumpbl of countries like the netherlands where it's a single payer system in the sense that government pays the bill, but it's private folks out there. private doctors and facilities. now, what we need to do is come up with a uniquely american way of providing care.

i'm not in favor of the canadian system, the british system, of a french system. that's not what max is working on. every one of us, what we've said is, we'll find an american solution because here in the united states, the majority of people get their health insurance on the job. so let's build on that system because for us to completely change that, it would be too disruptive. that's where suddenly people would lose what they have and have to adjust to a new system. and max and i agree that's not the way to go. all we've said is in building a better system, what are the elements? well, number one, for people like you, you should be able to get some help going into the private insurance marketplace and buying health insurance. so we would give you a tax credit to help you obtain insurance.

now, the problem is if you're going out there on your own, then it's much more expensive than in a big group. so we would allow you to buy into a health care exchange that would give you some power to negotiate for a better rate because you're now part of a big pool. we would also make sure that if you do have insurance, that you are protected from some of the policies that we've talked about that have not been very good for consumers. so you wouldn't be able to be banned for preexisting conditions, caps on out of pocket expenses. so we would reform the insurance market for people that already have insurance. if we do those things, making it better for folks who have insurance, making it easier for you to buy insurance, and helping small businesses who want to do the right thing but can't afford it because they're charged high rates, if we do

those things, then we can preserve the best of what our system offers, but also make sure that people aren't as vulnerable. that's essentially what we're talking about with health care reform. when you hear people saying we're trying to get socialized medicine, have government bureaucrats mettle in your decision-making, that's just not true. all right? okay. it's a guy's turn. gentleman right there in the back. with the green. >> i think most of us know that medicare is one of the best social programs this nation's ever put together.

it works extremely well and helps the people who need it the most, but money doesn't grow on trees. how can we be assured that increasing coverage to others is not going to make medicare more expensive or less effective. >> i appreciate the question because a lot of seniors are concerned about that. first of all, it is important to know that medicare is a government program. so when you hear people saying, i hate government programs, but keep your hands off my medicare, then there's a little bit of a contradiction there. and i have been hearing that quite a bit. i want to be clear about that. medicare is a terrific program and it gives our seniors

security and i want it to be there for the next generation. but if we don't make some changes in how the delivery system works, if we don't eliminate some of the waste and inefficiencies in the system, we've proposed not to reduce benefits on medicare. it's not to ration. what we are asking is that we eliminate some of the practices that aren't making people healthier. example number one. subsidies to insurance companies under medicare amount to about $177 billion over ten years. that's how much we think we could save by eliminating subsidies to insurance companies that are offering what's called medicare advantage. it doesn't help seniors any more than regular medicare does. and so if we took that $177

billion, we're not making seniors worse off, but we've got that money now not only to strengthen the health care system overall, but potentially to cover more people. now, the insurance companies don't like it. but it's the right thing to do. let me give you another example of changing that we should make. right now, when you go into the hospital, you get a procedure under medicare. if you end up having to come back to that hospital a week later because something went wrong, they didn't do it right, the hospital doesn't pay any penalty for that. they just get reimbursed for a second time or a third time. same fee, same service. now think about that if cart -- auto repair shops operated the same way. you take your car in, get it fixed and a week later, the

thing's broken again. you go in, the guy says, let me charge you all over again. that doesn't make any sense. let's say to the hospitals, we're going to charge you for over all treatment of whatever the problem is. you get it right the first time, you get to keep a little extra money, but if you keep having the person coming back, then there's a disincentive. those are the examples of the kinds of changes that can be made that aren't reductions in benefits, but save the system money and by the way, it will actually increase the life expectancy of the medicare trust fund, which is in deep trouble if we don't do something. because as you said, money doesn't grow on trees. so we're actually trying to help preserve medicare and make

people healthier in the process. all right. young lady in the back there. right there. no, well, actually, i was pointing -- i didn't see you. right there. the young lady in the blue who stood up there. >> excuse me. >> good afternoon, mr. president. my name is sarah landry. sorry, i'm a little nervous. >> you're doing great. >> thank you. i'm a single mother of two children. i'm an msu student. i have a son that suffers from many disableties, he's disabled for the rest of his life. he's 11 years old. he suffers from autism. he's non-verbal. he serves from hard to control epilepsy and is diabetic. he has been sick ever since he

was 9 months old. my question is you is i rely heavily on his medicaid to support good health care for him. what would happen with this reform with his medicaid coverage? >> first of all, thank you for sharing your story. you are a heroic mom, so we are -- grateful to you and your son's lucky. if you currently qualify for medicaid, your son qualifies, he would continue to qualify. so it would not have an impact on his benefit levels and his ability to get the care that he needs. some of the reforms that we're talking about though, what i just referred to as delivery

system reforms where we help for example, encourage doctors when they are seeing a patient, instead of having five tests, do one test and then e-mail all the tests to five specialists. those kinds of changes can save money in the medicaid and medicare systems overall. and that will actually help the government, who has to come up with half the medicaid into his state budget every year. it will help him be able to pay for it. so, we're not changing the benefit levels of who qualifies for medicaid. we might see some expansion of medicaid in fact under the reforms that have been proposed in some of the legislation, but we do have to make the whole system over all just a little bit smarter, make sure we're getting a better bang for the buck so that the money is there for the services that your son

needs. okay? this also includes preventive care, wellness care. because our system really is not a health care system. it's more like a disease care system. all right. we wait until people get sick, then provide them care. now, think about it. are we better off waiting until somebody gets diabetes and then paying a surgeon for a foot amputation or are we better off having somebody explain to a person who's obese and at risk to change their diet and if they contract diabetes, to stay on their medications. obviously, the second is more cost efficient, but right now, the health care system is perverse. it does not insent vise those things that make people better or keeps them out of hospitals in the first place and that's where we have to change over all.

okay? it's a gentleman's turn and i'm going to call on that gentleman right there. right there. >> my name is randy -- >> hold on, randy. >> i'm from -- montana. as you can see, i'm a proud nra member. i believe in our constitution and it's a very important thing. i also get my news from the cable networks because i don't like the spin that comes from them other places. >> you've got to be careful about the cable networks. >> max baucus, our senator, has been locked up in a darkroom there for months now, trying to come up with some money to pay for these programs and we keep

getting the bull. that's all we get is bull. you can't tell us how you're going to pay for this. you're saving here. you're saving over there. take a little money here, there. but you have no money. the only way you're going to get it is to raise our taxes. you said you wouldn't. max baucus says he doesn't want to put a bill out that will, but that's the only way you can do that. >> i'm happy to answer the question. >> thank you. >> the -- look, you are absolutely right that i can't cover another 46 million people for free. you're right. i can't do that. so we're going to have to find resources if people who don't have health insurance are going to get some help, then we're going to have to find money from somewhere. now, what i've identified and most committees have identified

including max baucus's committee, let's say it cost 800 to $900 billion. that's a lot of money. that's over ten years though. all right? so that's about 90 billion, 80 to $90 billion a year. about 2/3 of it, 2/3, can be obtained by eliminating subsidies to insurance companies. so you're right. that's real money. i just think i would rather be giving that to the young lady here than to insurance companies making record profits. now, you may disagree. i just think that's a good way to spend our money. but you're point's well taken because even after we spend, after we eliminate some of the waste and have gotten the savings, that's only 2/3. we still have to come up with

1/3 and that's about $30 principa year. there are five different bills right now. this is all going to get merged in september. but let's assume it costs about $30 billion a year over ten years. we have to come up with that money. when i was campaigning, i made a promise that i would not raise your taxes if you made $250,000 a year or less. but i said that for people like myself who make more than that, there's nothing wrong with me paying a little bit more in order to help people who have got a little bit less. that was my commitment. so -- so what i said is -- so what i said is let's for example, just -- this is the solution i originally proposed.

some members in congress disagree, what i said is we could lower the itemized deductions that i could take on my income tax returns every year so that instead of me getting 36%, 35% deductions, i'll just get 28%. like people who make less money than me. if i'm writing a check to my local church, i don't know why uncle sam should be giving me a bigger tax break than the person who makes less than me because that donation means just as much. if we just did that, that alone would pay for the health care we're talking about. so my point is, number one, 2/3 of the money we can obtain just from eliminating waste and inefficiencies and the congressional budget office has agreed with that. republicans don't dispute it.

and then the other third, we would have to find additional revenue, but it wouldn't come on the backs of the middle class. now, let me make one final point. i know that there are some people who say i don't care how much money somebody makes, they shouldn't have to pay higher taxes and i respect that view. but the truth of the matter is is that we've got to get over this notion that somehow we can have something for nothing because that's part of how we got into the deficit and the debt that we're in in the first place. the -- when the previous administration passed the prescription drug bill, that was something that a lot of seniors needed. the price tag on that was

hundreds of billions of dollars. you know how we paid for it? we didn't. it just got added on to the deficit and the debt. so it -- it amuses me sometimes when i hear some opponents of health care reform on the other side of the aisle or these cable shows, yelling about how we can't afford this when max and i are actually proposing to pay for it and they pass something that they didn't pay for at all and left for future generations to have to pay for in terms of debt. that doesn't make sense to me. can i say this though? randy, i appreciate your question. the respectful way you asked it and by the way, i believe in the constitution, too. so thank you very much. appreciate it.

all right. right there in the green in the back there. yeah. that's you. that's you. >> okay. so when funding dried up last fall to the economic downturn, i lost my job at a nonprofit helping struggling teens, and i'd like to thank you because -- because of your stimulus going to community health clinics i now have a new job helping people -- >> that's great. >> -- mostly uninsured people with mental health issues. i'm a therapist. i wanted to thank you for that, but there was a gap in there where i lost my insurance in between losing my job at the nonprofit and my current job. i would like to ask you how you will help people with that gap when they're unemployed. >> well, first of all, the recovery package, the stimulus, helped people precisely with that gap when we said we'll cover 65% of the cost of cobra. how many people here have been on cobra or tried to get on

cobra? all right. so just for those of you who aren't familiar with it, if you lose your job, under federal law you're able to access something called cobra which allows you to pay the premiums for the health insurance that you had until you find your next job. sounds like a good deal. here is the only problem. as i said before, most of us don't realize how much our insurance costs our employers because we're not seeing the actual bill. it's being paid mostly by our employers. so when we lose a job, suddenly we get this bill for $1,000 or $1,200 or $1,500 a month, and that's absolutely the worst time for you to have to come up with that money is when you've lost your job. so what we did was we said because this is such an extraordinary crisis, let's pick up 65% of that temporarily so that the huge number of people who have lost their jobs because of this financial downturn, they get a little bit more of a

cushion. now, that was the initial help that we wanted to do to provide that bridge. when we passed health reform, you are going to be in a position where, first of all, you will be able to have selected a plan that you can carry with you whether you've loths yo last your job or not, and depending on your income levels, you will also be qualified for a tax credit that will help you pay and continue your coverage even if you've lost your job, and for a lot of people, this is especially important for a lot of people who are self-employed because increasingly, you know, if you're a consultant, you're somebody who has opened up your own shop a little mom and pop store somewhere, you are the people who have the toughest time getting insurance because you just don't have enough employees for the insurance companies to take you seriously. that's why what we want to do is

create an exchange -- it's like a marketplace where you can go and choose from a menu of different options, different kinds of plans that you think might be right for you. now, one of the options that's being debated is should there be a public option, all right? and i want to just explain this briefly because this is where the whole myth of a government takeover of health care comes from, and not everybody -- not even every democrat agrees on the public option, but i just want at least people to be informed about what the debate is about. the idea is if you go to that marketplace and you're choosing from a bunch of different options, should one of the options be a government-run plan that still charges you premiums, you still have to pay for it just like private insurance, but government would not -- this government option would not have the same profit motive.

it would be obviously like a not for profit, it would have potentially lower overhead, so it might be able to give you a better deal. should you be able to choose from that option among many others? that's what the debate is about. now, what the opponents of a public option will argue is you can't have a level playing field. if government gets into the business of providing health insurance, they will drive private insurers out of the health insurance markets. that's the argument that's made, and that is a legitimate -- it's a fair concern, especially if the public option was being subsidized by taxpayers, right? if they could just keep on losing money and still stay in business, after a while they would run everybody else out, and that's why any discussion of a public option has said that it's got to pay for itself, it's not subsidized by private

insurers. the only point i want to make about this is whether you're for or against a public option, just understand that the public option is not a government takeover of health insurance. everybody here who has currently private insurance, you know, you would more than likely still be on your private insurance plan. employers wouldn't stop suddenly providing health insurance. so that is where this idea of government-run health care came from. it is not an accurate portrayal of the debate that's going on in washington right now, all right? it's a gentleman's turn. this gentleman right there. right there. yeah. yes, sir. >> thank you. given your comments regarding the public option, i would like, if you could, to comment on the following and also welcome and thank you and i believe in reform as well. i have learned that medicare pays about 94% of hospital

costs, and i have learned that medicaid pays out 84% of hospital costs and i have learned this from a reputable source, my brother who is a chief administrative officer at a large hospital group. he also explains to me when i communicate with him that private insurers at his hospital collects about 135% of costs from private insurers and that makes up the difference. so if public option is out there, will it pay for its way or will it be underfunded like medicare and medicaid? thank you. >> it's a great question, and i'll try to be succinct on this. this is a complicated area. anybody who has ever gotten a bill from a hospital knows it's a complicated area, but here is the short answer. i believe that medicare should -- medicare and medicaid should not be obtaining savings just by squeezing providers. now, in some cases we should

change the delivery system so that providers have a better incentive to provide smarter care, right, so they're treating the illness instead of just how many tests are done or how many mris are done. let's pay for are you curing the patient, but that's different from saying we need to save some money so let's cut payments to doctors by 10% and see where that works out. that's where you do end up having the effect you're talking about. if they're only collecting 80 cents on the dollar, they have to make that up somewhere, and they end up getting it from people who have private insurance. this is true also, by the way, of emergency room care. each of us spend, even though we don't know it, our employer pays for it so we don't notice it on our tab. each of us spends about $1,000 per family, maybe $9